SG Leaders: Karim Halazun
Parissa Tabrizian
Summary: This protocol outlines the methodology for evaluating the outcomes of salvage LT for patients with HCC.
Liver resection is the primary treatment for Hepatocellular Carcinoma (HCC) in non-cirrhotic livers. However, in cirrhotic livers, where HCC often arises, the challenges of tumor burden and compromised liver function makes resection often unfeasible. As such, primary liver transplantation is the preferred therapeutic approach, particularly in those meeting the recommended guidelines. However, scarcity of suitable donors and prolonged wait times influence the potential benefits of LT. To address this challenge, salvage transplantation (ST) has been advocated for patients who have undergone primary liver resection for HCC, or experienced HCC recurrence, or suffered from decompensated liver function. ST offers liver resection as a temporary bridge therapy while awaiting LT, and can allow liver resection to be used as an efficient downstaging tool . However, long term outcomes of ST remain unclear. Limited data are available regarding the OS and DSF, and there is paucity of literature directly comparing ST to upfront LT. Our aim is to evaluate ST both in the setting of recurrent HCC and when liver resection was intentionally used as a downstaging tool.
